Acquired communication disorders

WK7

what are acquired communication disorders?

Disorders affecting speech, language, or cognition due to brain damage after a period of normal development

what area of the brain is involved in language production?

Broca’s area (left frontal lobe).

what area of the brain is crucial for language comprehension

Wernicke’s area (left temporal lobe).

What communication disorder may result from cerebellar damage?

Ataxic dysarthria.

three causes of acquired communication disorders

Stroke, traumatic brain injury, neurodegenerative disease.

What is the key difference between speech and language disorders?

Speech disorders affect motor output; language disorders affect understanding or forming language

What is an example of a acquired speech disorder

Dysarthria.

What is an example of a acquired language disorder

Aphasia.

Does a speech disorder affect language comprehension?

No, comprehension is typically intact.

Is intelligence affected in speech disorders?

No, intelligence is usually unaffected.

What is fluent aphasia also known as?

Werncike’s aphasia

what is non fluent aphasia also known as?

Broca’s aphasia

What is a key feature of fluent aphasia?

Fluent, but non- sensical speech with poor comprehension

What is a key feature of non fluent aphasia?

Halting, effortful speech with good comprehension

Which brain area is affected in fluent aphasia?

Werncike’s area

Which brain area is affected in non fluent aphasia?

Broca’s area

Are individual’s with non fluent aphasia aware of their errors?

Yes, often aware

What psychosocial impact is common in fluent aphasia?

Frustration due to being misunderstood and being unaware of errors

What psycho-social impact is common in non fluent aphasia?

Depression, and becoming socially withdrawn due to difficulty in expressing thoughts

What symptoms does a stroke affecting the left side of the brain cause?

A stroke affecting the left side of the brain causes weakness in the right side of the body. This is called left sided dominance

What is the frontal lobe responsible for

includes primary motor cortex

pre frontal cortex- reasoning, abstract thought, decision making, pragmatic behaviour

What is the temporal lobe responsible for

includes primary auditory cortex

• language association area (Werncike’s area)

• auditory association cortex

What are the steps needed to produce speech

1. respiration

2. phonation

3. articulation

4. resonation

   often with neurological changes that are progressive it can be the speech that is affected first

What are motor speech disorders

A general term referring to a breakdown in control over muscular speech movements as a consequence of central or peripheral nervous system damage

disorders of speech resulting from neurologic impairment affecting the motor programming or neuromuscular execution of speech

Incidence and prevalence of acquired speech disorders

• precise figures are unknown

• estimated that about 70% of non-comatose people who have had a stroke suffer from some kind of speech and language impairment (Weinfeld, 1981)

• Dysarthria 46%

• Apraxia of speech 4.6%

What is a cognitive communication disorder?

Communication issues caused by cognitive deficits (e.g., in memory, attention, executive function).

What speech rate is typical in apraxia of speech

around 1.4 syllables per second

What is the most common type of dementia?

Alzheimers disease

What type of aphasia includes word finding difficulty but fluent speech

Anomic aphasia

Why is raising awareness of aphasia important?

To reduce social exclusion and improve support systems

What are the psycho social impacts of aphasia?

Isolation, depression, identity disruption, employment challenges

fluent aphasia challenges: frustration, embarrassment, frustration with culture- Te Reo Māori: losing your language and culture

What are the five different types of dysarthria?

1. spastic dysarthria

2. taxic dysarthria

3. hypo connetic

4. flacid dysarthria

5. hyper connetic dysarthria

Common frustrations for people with dysarthria

is that they sound "drunk" when trying to speak

Another common frustration is difficulty keeping food/fluid in their mouth. While this is not a communication difficulty it also contributes to poorer quality of life (with reduced enjoyment of social functions)

What are the difficulties associated with right hemisphere language disorder?

People with RHD often have difficulty understanding inferences

integrating verbal information into an overall theme

ignoring unneeded information

making revisions to accompany new information

not all patients present the same

tend to have compromised attention, memory, visuospatial and executive functioning skills

What is aphasia?

language difficulty when all other intellectual, motor and sensory functions are intact

for most people aphasia is caused by a stroke in the left cerebral hemisphere it can be caused by other neurological events such as

• viral encephalitis

• brain tumor

Single word difficulties associated with aphasia?

• word finding difficulty is most consistent

• circumlocution (talking around the word)

• paraphasia’s

• approximation of the target word

• neologisms

• no or minimal obvious relationship with target word

What is fluent aphasia

• relatively fluent verbal output

• relatively poor comprehension

• preservation of function words

• errors of substitution

• poor awareness of errors

Non fluent aphasia

Relatively non fluent verbal output

• relatively good comprehension

• pre-dominance of content words

• errors of omission

• good awareness of errors

Issues in aphasia

Differential diagnosis- is there any point?

two main sources of confusion

people with co-existing disorders

many disorders share the same speech and or language symptoms

impact of this on diagnosis prognosis or treatment

this is important because some of these language difficulties can be caused by other things